Right myocardial infarction with predominant right ventricular dysfunction

Two patients with right ventricular myocardial infarction are described. In both cases, the hemodynamic criteria established for this diagnosis were fulfilled, namely, right-side pressure values (central venous pressure and right atrial pressure) equal to or higher than left-side pressure values (pulmonary capillary wedge pressure and left ventricular end-diastolic pressure). ECG tracings showed acute diaphragmatic myocardial infarction. The lungs were clear both clinically and radiologically. The diagnosis of right ventricular myocardial infarction was confirmed in the first patient by hemodynamic studies and at autopsy, and in the second patient, by hemodynamic and echocardiographic studies. Only in the second care was the administration of massive quantities of fluids and dopamine followed by good results. The importance of establishing a precise diagnosis of right ventricular myocardial infarction is emphasized, since therapy for this condition is different than that for left ventricular myocardial infarction.